A multi-institutional study of patient-derived gender-based discrimination experienced by resident physicians.

BACKGROUND: This study characterizes prevalence, frequency, and forms of patient-derived gender-based discrimination (GBD) experienced by resident physicians, as well as their experiences witnessing and reporting patient-derived GBD. METHODS: A web-based survey was sent to residents from 12 programs at three academic institutions. RESULTS: Response rate was 47.9% (309/645) with 55.0% of respondents identifying as women. Women were more likely than men to experience patient-derived GBD during residency (100% vs 68.8%, p < 0.001), including inappropriate physical contact, receiving less trust from patients, and being mistaken for a nurse (p < 0.001). While 85.9% of residents personally experienced and 95.0% of residents witnessed patient-derived GBD, only 3.4% of residents formally reported patient-derived GBD. Women were more likely to report negative personal and professional consequences of patient-derived GBD. CONCLUSIONS: Patient-derived GBD is pervasive and disproportionately affects women residents. Current reporting mechanisms are not adequately capturing nor addressing patient-derived GBD.

Differences in Sexual Health Outcomes Between Adolescents in Public Schools and Juvenile Correctional Facilities.

Data from a statewide, anonymous survey were used to test for differences between adolescents' sexual health behaviors and their outcomes across settings. Youth in juvenile correctional facilities (JCFs) were disproportionally male and Black compared to their peers in public schools. Youth in JCFs were significantly more likely than their peers to report that they had ever had sex, used substances prior to last sex, or been involved in a pregnancy. They were less likely to have used condoms or contraception at last sex, or to report having talked with their partners about sexually transmitted infections or birth control. The results highlight the importance of comprehensive sexual health education and access to a reproductive health provider for students in JCFs.

Corrections officers' knowledge and perspectives of maternal and child health policies and programs for pregnant women in prison.

BACKGROUND: In response to the dramatic increase in the number of women incarcerated in the United States-and a growing awareness that a small proportion of women enter prison pregnant and have unique health needs-some prisons have implemented policies and programs to support pregnant women (defined here as maternal and child health [MCH] policies and programs). Corrections officers (COs) are key stakeholders in the successful implementation of prison policies and programs. Yet, little empirical research has examined prison COs' knowledge and perspectives of MCH policies and programs, particularly the impact such policies and programs have on COs' primary job responsibility of maintaining safety and security. The objective of this mixed-methods study was to understand COs' knowledge and perspectives of MCH policies and programs in one state prison, with a specific emphasis on the prison's pregnancy and birth support (doula) program. RESULTS: Thirty-eight COs at a single large, Midwestern women's prison completed an online survey, and eight of these COs participated in an individual, in-person qualitative interview. Results indicated that COs' perspectives on MCH policies and programs were generally positive. Most COs strongly approved of the prison's doula program and the practice of not restraining pregnant women. COs reported that MCH policies and programs did not interfere, and in some cases helped, with their primary job task of maintaining safety and security. CONCLUSIONS: Findings support expansion of MCH programs and policies in prisons, while underscoring the need to offer more CO training and to gather more CO input during program development and implementation. MCH services that provide support to pregnant women that are outside the scope of COs' roles may help reduce CO job demands, improve facility safety, and promote maternal and child health.